02/15/2013    

HEALTHCARE FRAUD NEWS

DOJ and HHS Announce Record-Breaking Healthcare Fraud Recoveries

Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius have released a new report showing that for every dollar spent on healthcare-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Healthcare Fraud and Abuse (HCFAC) Program.

The new authorities under the Affordable Care Act granted to HHS and the Centers for Medicare & Medicaid Services (CMS) were instrumental in clamping down on fraudulent activity in healthcare. In FY 2012, CMS began the process of screening all 1.5 million Medicare-enrolled providers through the new Automated Provider Screening system that quickly identifies ineligible and potentially fraudulent providers and suppliers prior to enrollment or revalidation to verify the data. As a result, nearly 150,000 ineligible providers have already been eliminated from Medicare’s billing system.

Source: U.S. Department of Health & Human Services